糖化血红蛋白水平检测对冠心病患者冠状动脉病变程度的评估价值

Value of glycosylated hemoglobin level in evaluating the severity of coronary artery disease in patients with coronary heart disease

目的探究糖化血红蛋白(HbAlc)水平检测评估冠心病(CHD)患者冠状动脉病变程度的价值。方法检测并比较冠状动脉狭窄程度<50%(Ⅰ组,135例)、冠状动脉狭窄程度≥50%且Gensini积分<15分(Ⅱ组,116例)、冠状动脉狭窄程度≥50%且Gensini积分≥15分(Ⅲ组,98例)患者的冠状动脉病变支数、血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、空腹血糖水平、餐后2 h血糖水平和糖化血红蛋白(HbA1c)水平。结果Ⅲ组的冠状动脉病变支数为多支的比例、空腹血糖和餐后2 h血糖水平均高于Ⅱ组,Ⅱ组高于Ⅰ组,差异有统计学意义(P<0.05);3组HbAlc和Gensini评分比较差异有统计学意义(P<0.05)。HbAlc和Gensini评分呈显著正相关(P<0.05)。ROC曲线分析显示,HbAlc水平评估CHD患者冠状动脉病变程度的AUC为0.704,95%CI为0.615~0.843,诊断界点为6.37%,敏感性为71.49%,特异性为58.36%。结论HbAlc水平检测可较好评估CHD患者冠状动脉病变程度。

Objective To investigate the value of HbAlc level in evaluating the severity of coronary artery disease in patients with coronary heart disease(CHD).Methods 135 patients with coronary artery stenosis degree<50%(group Ⅰ),116 patients with coronary artery stenosis degree≥50% and Gensini score<15 points(group Ⅱ),and 98 patients with coronary artery stenosis degree≥50% and Gensini score≥15 points(group Ⅲ)were selected.The number of coronary artery lesions,and the levels of serum total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL),fasting blood glucose(FBG),2-hour postprandial blood glucose and HbA1c were compared.Results The proportion of multi vessel coronary artery disease,FBG and 2-hour postprandial blood glucose in group Ⅲ were higher than those in group Ⅱ(P<0.05).These indexes in group Ⅱ were higher than those in group Ⅰ(P<0.05).Threre were significant differences in HbAlc and Gensini score among the three groups(P<0.05).There was a significant positive correlation between HbAlc and Gensini score(P<0.05).ROC curve analysis showed that the AUC of HbAlc level in evaluating the severity of coronary artery disease in patients with CHD was 0.704,95%CI was 0.615-0.843,the diagnostic cut-off point was 6.37%,the sensitivity was 71.49%,and the specificity was 58.36%.Conclusions HbAlc level has a good diagnostic value in evaluating the severity of coronary artery disease in patients with CHD.